Who is the actual employer

Specialties Home Health

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My friend who is a nurse and I were debating a topic. My friend has been working in homecare for a family for six years. The family has used several agencies, and my friend has had to register with these agencies to continue to work with the family. The family and my friend arrange the schedule and the agency nurse asks the mom and dad questions to fill out her evaluations because this agency nurse/supervisor doesn't directly work with her. The info for her evaluations comes primarily from the family. My friend wants to get a weekend job so she wants to know in reality who is the employer. If the family called and said they no longer required her services her job would end. She never deals with the agency except to pick up her check everything is done between my friend and the family. Except the issuing of a paycheck so how does she fill out the application, because the family knows her actual start date whereas the agency only knows her start date with them (which is 2 years) but she has been with the family for six years. How should she fill out the employer part to reflect her longtime work relationship with only this family and keep it simple for prospective employers for her potential weekend job.

Life tip: He who's name is on your check is your employer.

The family is your client but this does not mean that you cannot list them on your resume. It is not uncommon to list accomplishments, assignments, clients and the like on resumes.

Keep in mind though that the family is protected under HIPPA.

The parents gave her a letter of reference and told her she could list them as her employers. The mother works in healthcare and told her to use her as a reference is that still a violation?

If they write a letter then I would consider it a waiver of HIPPA but I would consider it very unprofessional. Nursing is not construction, hairdressing, or babysitting. I personally think it crosses the professional boundary. Despite being non-monetary, it is still a form of tip.

Her reference should come from her employer, who actually employed her, not the vulnerable patient and/or family.

I will admit though that this is a gray area and many here will think it is perfectly fine. To me it just doesn't pass the smell test.

"Is it illegal, immoral, or is there personal gain?"

She hasn't used it we just were discussing it, and wanted opinions. She just wanted to accurately reflect her employment. There have been three employers but technically one employment. Each agency may give a different accounting of her employment because they lost revenue when the case was transferred by the family.

You need to go over to the PDN forum.

But since i am private duty and work with agencies,your friend did 2 things wrong....

!. She totally crossed the nurse pt relationship boundaries.

How,you may ask...the parents are not your friends. They are patients,not friends.

If you had a pt in the hospital,would you ask them for a reference? No

2.She has been with these agencies and does not know that its the agencies that employs her?

Weird

Its also wierd that the agencies have the familiy evaluate her.

No agency that i worked for had the family evaluate the agency employee.

Who comps your friend on nursing skills?

Does said pt have a trach/vent?

Is there a nursing supervisor at the agency?

Specializes in Pedi.

The employer is obviously the agency. On her resume, she would have to list the 3 separate agencies:

Agency ABC 2012-present

Agency DEF 2010-2012

Agency GHI 2008-2010

She can make it known in her cover letter that she has worked with the same family for the duration of her employment as a PDN.

Who employs her is the agency. That would be free at any time to use her in whatever case they would like to. Which I am surprised that she doesn't ask the agency for some per diem work on the weekends. I am sure that the parents give input on how the nurse is doing as far as if they are satisfied with her work, however, I am sure that there must be other input. Is there other nurses on this case? Other disciplines? I am sure they are mindful of taking over care when your friend reports off. Additionally, someone needs to be auditing her charts for reimbursement. Not to mention caseworkers who may be there the same time as this nurse. Most agencies also have meetings regarding case load at least monthly. Again, people other than the family should be aware of her work.

However, the parents are the parents of her client/case. They should not be writing a letter on her behalf. No matter if they think she hung the moon. They do not pay her salary, hence, they do not employ her. They have the right to privacy, and that boundry should not be crossed no matter how well intended. And there's been more than one instance that a nurse crossing a professional boundry has been taken off of a case.

The issue here is that this private duty is not self pay. So although the parents may have input, the agency ultimately calls the shots. And that is the reality that your friend needs to realize. And a number of agencies do not allow families to offer any type of "gift" including outing themselves in a glowing letter of reference. Regardless if the mother is in health care or not--even more so, she should know better.

I wonder why the family kept switching agencies(if it was the family).

Thank-you all for answering the question. No other nurses work my friends case. If she calls off the agency doesn't have a nurse to cover her. The agency will not allow her to work any extra hours, hence trying to work somewhere else for hours. She actually has very little contact with the agency besides a paycheck. They refer most matters of the case to her, including dealing with the payor of the case. My friend is actually going to be leaving soon, because there isn't any room for illness, emergencies etc. Due to no backup nurse because the family will not allow anyone else to take care of their child. The family has had many negative issues with the agencies and nurses they have sent so that is why they have become that way. (only will allow one nurse into their home). After looking at you guys responses my friend is thinking now that she isn't working in the best situation. She has a lot of responsibility, and she wants options like everyone else who works . Vacation days, sick days etc.

It is too bad things have turned out this way and now she finds that she needs to extricate herself. This shows some of the pitfalls of engaging in these long term, exclusive relationships. Your friend needs to start over at a new agency, as the employing agency is not accepting of her. If they were, she wouldn't be an outcast and would have the opportunity of other case work now.

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